Organization
LAKE STEVENS VISION CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY ALAN WINDHORST O.D. (PRESIDENT)
(425) 334-4016
Entity
Organization
Contact information
Practice address
515 STATE ROUTE 9 NE STE 104, LAKE STEVENS, WA 98258-8523
(425) 334-4016
(425) 334-4017
Mailing address
515 STATE ROUTE 9 NE STE 104, LAKE STEVENS, WA 98258-8523
(425) 334-4016
(425) 334-4017
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1315TX
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2011146
—
WA
Enumeration date
03/13/2007
Last updated
11/25/2008
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